Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MATTHEW CHARLES REVILLA, PA-C
Active Sole ProprietorMATTHEW CHARLES REVILLA, PA-C is a Physician Assistant healthcare provider located in PALMETTO, Georgia. NPI 1821617036 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · PALMETTO, GA
Registration Details
- NPI Number
- 1821617036
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 9, 2020 (6.3820436430417 yrs)
- Last Updated
- Aug 27, 2021
- Licenses
-
9684 (GA)9684 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
507 PARK STPALMETTO, GA, 302681007Browse GA providers · Browse ZIP 30268
- Phone
- 7704634644
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in PALMETTO, GA
| Name | Credential | NPI |
|---|---|---|
| MS. ISABEL MARIA SOLES | PA | 1699843953 |
| EMMA ANN KEMINK HERNDL | PA-C | 1043908916 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.